[Adenocarcinoma of prostate in men younger than 50--rectal palpation mandatory with micturition problems]

In three men, aged 44, 47, and 48 years, prostatic carcinoma was diagnosed after a long delay, more than eight months after the onset of symptoms (obstructive and irritative micturition problems, erectile dysfunction, and haemospermia). The cancer was suspected on eventually performed rectal palpation and confirmed in biopsies. The serum prostate-specific antigen (PSA) levels were moderately increased. All were treated with goserelin and flutamide and radiotherapy on the emerging metastases (two patients). Two patients died, the third one, who had received antibiotic treatment for three months because at first prostatitis was suspected, was still in remission at the last follow up. Prostate cancer in young men is rare and may demonstrate aggressive biological behaviour. The age group less than 50 years of age accounts for 0.8% to 1.1% of all patients with prostate cancer. This form of the disease responds poorly to radiation or hormonal therapy and is often already too advanced for surgery. The symptoms at presentation of prostate cancer in young men are quite similar to those in prostate cancer patients beyond the fifth decade. When carcinoma grows beyond the margins of the prostate the prognosis is poor. In all men with micturition problems, rectal palpation of the prostate should be carried out as a routine.